Dilemma for doctors: America's problem with opioid prescribing b - KCTV5

Dilemma for doctors: America's problem with opioid prescribing becoming more complex

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As the opioid crisis continues and grows, questions remain about how else the problem can be handled. (AP) As the opioid crisis continues and grows, questions remain about how else the problem can be handled. (AP)

For nearly 20 years, Jamey Brooks struggled with overcoming an opioid addiction.

“I was probably 25 when I injured my back, I was working at a hospital in the nursing department,” said Brooks, “I was doing a lot of lifting so I herniated a disk in my lower back.”

That injury would spiral Brooks life down a treacherous path. At the time, the proper pain management called for opioids following his surgery.

“Initially, they started prescribing me the typical pain medications, like Vicodin, Loracet, Loratab, things like that,” Brooks recalled. “Then it progressed to longer lasting opiates, eventually I got up to literally a fentanyl patch that I wore 49 that delivered fentanyl subdermallyy to my skin.”

For years, the need to handle his pain would run his life.

“There was nothing left I was on the street, I was homeless, penniless, living hourly, daily to get what I needed to live until I realized that it just wasn’t sustainable anymore,” he said.

At one point, he says was using $1,000 a day in heroin.

“I couldn't sustain it physically, emotionally, it just was impossible," Brooks said.

When asked why he say anything to his doctors, Brooks said, “I didn't want it to stop. To me, within my head I felt like I was better than I was before or without the medications.”

Doctors say the problem is becoming more complex. Not only are they trying to help manage the pain of their patients, they’re dealing with people who demand opioids for their pain -- all the while, doctors are working to find a balance with varying levels of pain tolerance making it difficult to know how much to prescribe.

“What is the number of pills that person A would use versus person B,” asked Dr. Talal Kahn and director of chronic pain at University of Kansas Health Systems. “There are a lot of differences in their genetic makeup, perhaps their previous pain experiences, perhaps the way they perceive pain or whether or not they've even had a previous chronic pain issue that really ramps up their requirements for these kinds of medications.”

Kahn says those questions are just one part of the issue with opioids -- both if too much is prescribed or if not enough is prescribed.

“Often they find their way into the hands of people for whom they were not originally prescribed. It might also be that the individual starts using that medication for another pain condition that they might have developed, not for the condition which it was prescribed,” says Kahn. “Also, it must be incredibly frustrating if you are under prescribed medications now you're three days out, you're still hurting a lot from your knee orthoscopy perhaps and you can't get to your physician’s office or you don't have anyone else to prescribe those medications to you.”

While striking that balance can be hard, doctors are actively trying to achieve it: both with prescriptions and with treatment.

Those balances are how Brooks finally found a treatment that worked.

Three years ago, he enrolled in a medication assisted program that uses other substances like methadone to help people move past their opioid addiction.

“These medications are medically safe to prescribe,” said Dr. Amad Din, one of the many doctors involved with Brooks' treatment. “They are given under medical supervision. These medications reduce the cravings and hunger associated with the opiates that urges a person to use heroin or other illicit substances over and over again.”

Brooks says with this help, he has been able to look back at the lost years with clarity.

“I've gone through that period of time where physically I'm better, emotionally I'm a lot better and so now I'm able to start rebuilding that life that I worked so hard to destroy," he said.

Across the country, hospitals and pharmacies are working to come to a consensus on partial fills for prescriptions, to prevent medication from getting in the wrong hands.

At the same time, they’re working on more education for surgeons to determine what is the right amount of medication for each specific procedure.

In the meantime, they point out if you have any additional medication that isn’t needed, reach out to your local pharmacy to determine the best way to get rid of the extra drugs. 

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